A survey of reservoir hosts in two foci of cutaneous leishmaniasis in Kerman province, southeast of Iran

In the Old World, cutaneous leishmaniasis (CL) is zoonoses and natural vertebrate hosts of CL parasites are mammals. This study was carried out on natural infection rates of Leishmania parasites in reservoir hosts in one new focus of zoonotic cutaneous leishmaniasis (ZCL) and in suspected reservoir in an old focus of ACL in Iran. The sampling of rodents using Sherman traps was carried out and PCR technique was used for detection and identification of Leishmania species in Bahreman district, Kerman province, southeast of Iran. In addition, the smears were taken from suspicious lesions in stray dogs in the city of Kerman, the center of Kerman province. Simultaneously, pieces of lesion (1 9 191 cm) were taken for further histopathological examination. Overall, 25 rodents were collected and identified, including Meriones libycus and Rhombomys opimus. Amastigotes were observed in 33 % of the R. opimus by microscopic examination and indentified as Leishmania major by PCR technique. Four suspicious dogs out of 391 stray dogs showed no Leishmania species. To the best of our knowledge, this is the first isolation and identification of L. major from R. opimus in Kerman province, where ZCL has been present in recent years. Therefore, R. opimus is considered as the main animal reservoir host in Bahreman ZCL focus. In ACL focus such as the city of Kerman, dogs had no role in CL infection as reservoir host

Factors related to 6-month mortality after the first-ever stroke

BACKGROUND AND OBJECTIVE: Stroke is the second leading cause of death worldwide and the number of stroke cases has increased remarkably over the last 20 years. This study aimed at identifying predictors of with 6-month mortality of first-ever stroke patients and the factors contributing to it in East Azerbaijan province. MATERIALS AND METHODS: A closed cohort study was carried out from April 2014 to December 2014. All cases of first-ever diagnosed stroke were included in the study. Any transient ischemic attack, silent brain infarctions, and the stroke cases which were neither associated with trauma, blood disease nor with malignancy were excluded from the study. The variables of this study include participants' demographic characteristics, stroke severity National Institutes of Health Stroke Scale (NIHSS), and stroke risk factors. Patients were followed up within 6 months. To determine the survival time, the log-rank method was applied to compare intergroup differences. The tests include the univariate and multivariate analysis Cox regression. P < 0.05 were considered as statistically significant. RESULTS: A total of 576 cases of stroke were included in this study. Average age of ischemic and hemorrhagic stroke was 70.15 ± 13.0 and 67.79 ± 12.69, respectively. Case-fatality rate (CFR) of stroke patients was 49.2 and 21.7% in hemorrhagic and ischemic stroke types, respectively. Factors contributing to stroke mortality events include the severity of stroke (NIHSS categories 15–19 and ≥20), age over 65, being female, high body mass index and hyperlipidemia. In the final model, the severity of stroke (with NIHSS 15–19 with hazard ratio (HR) 4.22 (95% confidence interval [CI] 2.36–7.56) and NIHSS ≥20 with HR 5.34 (95% CI: 2.81–10.12) and age above 65 with HR 1.61 (95% CI: 1.02–2.51) were the most important predictors of 6-month mortality. CONCLUSION: Severity of stroke by NIHSS was the most prominent factor in stroke patients' mortality. By increasing the follow-up time, a better evaluation of the predictors of mortality after stroke can be achieved